War on Ivermectin: The Medicine that Saved Millions and Could Have Ended the Pandemic

PART ONE

GEARING UP FOR BATTLE

CHAPTER ONE

Before the Beginning

Here’s to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They’re not fond of rules. And they have no respect for the status quo. You can quote them, disagree with them, glorify or vilify them. About the only thing you can’t do is ignore them. Because they change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world are the ones who do.

—Steve Jobs

I do quite a bit of public speaking these days, and part of my schtick has become somewhat of an ode to the old Pierre. When I say old, of course, I mean pre-Covid.

Old Pierre believed that the elite, esteemed medical journals represented the best of scientific thought and study. The Lancet or the New England Journal of Medicine said so? It was settled then. Old Pierre religiously read the New York Times from cover to cover, because it was the paper of record; the arbiter of truth. If you wanted to know what was really going on, you read the Times. Period. He voted for Biden (although in his defense, he wasn’t exactly a fan and never put a BIDEN-HARRIS ring around any of his social media profile photos), trusted the government (I know!), and actually believed that public health agencies were committed to safeguarding and improving . . . wait for it . . . public health. He knew—knew, I tell you!—that vitamins were a scam and that hospitals were life-saving centers of care, compassion, and excellence. Old Pierre dutifully lined up for his own annual flu shot and followed the childhood immunization schedule to the letter with his three daughters.

He was a clueless sonofabitch.

Nobody, least of all me, could have predicted the insane series of events, discoveries, and decisions that would transform him (me) into the wildly different doctor—and man—that I am today.

But here we are.

So this is my story. What started as a daily brain dump, a place to record the happenings and heartbreaks occurring at work and at home, slowly morphed into this crazy peek into a decidedly broken medical system. I set out to understand and expose what was happening with repurposed drugs, ivermectin specifically. By October of 2020, we had identified an inexpensive, safe, widely available medication that was showing tremendous potential not just as a treatment for Covid but also as a preventative. As the weeks and months wore on, the data supporting its safety and efficacy were astounding. And yet the backlash against it was swift and furious. Positive studies were overturned and retracted. Negative studies appeared out of thin air. Around the world it was quietly being used to tremendous, almost impossible success, and yet doctors were punished for prescribing it, pharmacies refused to fill valid prescriptions for it, and the media would only touch it to call it the horse dewormer. To a physician fighting on the front lines of this battle, this systematic smear campaign was unfathomable.

I soon discovered that the corruption and deceit were hardly limited to the pharmaceutical space. The entire medical industrial complex—including our governmental and international regulatory agencies, Big Pharma, public and private health care systems and hospital networks, medical schools and their journals, and at least one centi-billionaire philanthropath—had been collectively captured. According to Wikipedia (which I don’t often use as a reference source, incidentally, but their explanation was most succinct), When regulatory capture occurs, a special interest is prioritized over the general interests of the public, leading to a net loss for society.¹

You can say that again.

At the risk of sounding arrogant or self-congratulatory, when it came to Covid, I got a lot of things right from the beginning. So often and so overwhelmingly, in fact, that I was dubbed Lucky Pierre, first by the editor of the New England Journal of Medicine in a magazine interview, and then by my colleagues and friends. I want to acknowledge here, up front, that I ascribe much of that consistent, almost implausible rightness to this: practically from day one, I was part of a group of highly credible, extensively experienced professors, scientists, and clinicians who were deeply studied on nearly every aspect of medicine even remotely related to Covid. We shared a spirit and a purpose well before we had a name (the Front Line Covid Critical Care Alliance, or FLCCC), a website, or a nonprofit designation.

The whole is always greater than the sum of its parts, and that is exponentially true with the FLCCC. After all, we’re the misfits, the troublemakers, the round pegs in the square holes. We’re the ones standing up to the system; the child watching the bare-assed Emperor parade down the street who just can’t hold his tongue.

"But he hasn’t got anything on," we’ve been shouting. At first, people pointed and laughed at us and called us names, but we didn’t care. That fat bastard was naked, and nothing could make us see or think otherwise! And do you know what? People are starting to catch on. More and more, some might say in droves, they’re seeing what we see and have seen for a few years now.

That is the power and spirit of the collaboration and camaraderie behind the FLCCC. From the beginning, we were bound by mutual passion and respect, and committed to uncovering and speaking the truth—no matter how difficult or isolating that proved to be.

So yeah, we’ve gotten a lot right. It turns out, that’s actually not so hard to do when you’re surrounded by greatness and your hearts are in the right place.

CHAPTER TWO

Foreshadowing

Feck, feck, feck, Paul yelled. (That’s how Paul sounds when he curses in his South African accent). It’s negative!

What? I asked.

It’s fecking negative!

What do you mean? How the hell can it be negative?

I don’t know, Paul bellowed. I just got the paper and I’m already at the airport. Those bastards purposely didn’t send it to me on time!

I need to see it, I insisted.

I’m not supposed to share it, it’s embargoed until Thursday.

Screw that, Paul! Now I was yelling, too. Send it to me. I have to see it. It’s negative for everything?

Everything.

Even the time on vasopressors?

Yes.

Mortality and length of stay?

Yes.

"Paul, they did something stupid. We know it works, there’s no way the study could be negative. It’s not possible!"

Paul’s reaction was more than justified. He had just learned that the world’s first large, prospective, multi-center, double-blind, randomized controlled trial on the impacts of high-dose intravenous vitamin C (IVC) in septic shock was negative—meaning that the trial concluded it had no impact on any important outcome in the patients treated.

Paul and I both knew that this was utter bullshit.

Paul Marik isn’t just an accomplished physician and researcher, or a former tenured professor of medicine, or the author of hundreds of peer-reviewed journal articles and four critical care textbooks. Paul is also an IVC expert, renowned for developing a lifesaving protocol used to treat sepsis, a condition that causes more than 250,000 deaths per year in the US alone, and according to research published in 2020, is the leading cause of death worldwide—above cancer and cardiovascular disease.¹

That conversation happened on January 16, 2020, before the words Covid-19 and pandemic were staples in the global vocabulary. Paul was on his way to an international conference in Belfast, Ireland, called Critical Care Reviews, which would feature an unveiling of the results of the previous year’s most important trials in ICU medicine. There were a lot of eyes on this conference because the medical world was anxiously awaiting the results of the first randomized controlled trial of IVC in sepsis, moderated by the great Paul Marik.

It was also going to be the first time Paul and I met in person after spending countless hours on the phone as friends and colleagues over the prior two years. We had no idea that this conference would be consequential for entirely different reasons than we had anticipated.

It has taken the painful clarity of hindsight to realize how naive and ignorant we were then, at least in regard to the academic medical system—one we had been practicing, researching, and teaching in for decades. We were wholly unaware that the events about to unfold over the next two days would be the start of what has turned into a relentless three-year battle with a medical system we’ve since discovered has been completely corrupted and captured by the pharmaceutical industry.

I would argue that Paul should be more embarrassed about his ignorance at that time than I, as he had long been considered a pioneer in medicine. He was trained in Critical Care, Neurocritical Care, Pharmacology, Internal Medicine, Anesthesia, Nutrition, and Tropical Medicine and Hygiene, and was a tenured Professor of Medicine and Chief of the Division of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School (EVMS) in Norfolk, Virginia. He has published over 500 peer-reviewed journal articles, written eighty book chapters, authored four critical care books, and has been cited over 43,000 times in peer-reviewed publications. In medicine, scientists are given a ranking of their impact to their field by way of something called the h-index; Paul has an h-index of 110. For reference, a typical h-index for a professor ranges from 12 to 24, and most Nobel Prize winners score 30 or above. What I’m saying is, Paul is a fecking force. Further, he has delivered over 350 lectures at international conferences and visiting professorships and won numerous awards, including the National Teacher of the Year award by the American College of Physicians in 2017.

At the time of the Belfast conference, I was a mere twelve years out of training. Paul had decades of practice under his belt. I was—and still am—a rookie compared to him. That conversation would mark the beginning of our journey together, not only because of its timing, but more so in terms of how it so powerfully pitted us against the broken academic medical system.

All the corruption, the disinformation, the fraudulent trials, and the editorial attacks on IVC would start with this day. Of course, we did not yet know about the root cause of it all: a systematic corruption in the medical sciences by an industry that has been targeting repurposed drugs, vitamins, and alternative therapies for decades.

When we read the study, we quickly picked up the investigators’ mistake: they had given Paul’s vitamin C protocol too late into the disease. Our reaction to this discovery was more disappointment than anger, as we simply and naively assumed that the trialists designed the study out of ignorance of the importance of timing of interventions in critical care. It almost makes me laugh that that was my actual interpretation of the outcome. These were world renowned critical care experts, mind you, and they had allegedly designed a trial where patients in septic shock would not receive the study treatment for up to as much as thirty hours at our best estimate. These elite trialists had ignored the core concept of critical illness resuscitation, which is the importance of the golden hour, meaning with every minute or hour that goes by before instituting effective therapy, the probability of improvement rapidly diminishes.

I ask you: How do critical care physicians, researchers, and academics running a potentially ground-breaking trial forget such a fundamental concept? How does something so significant in the setup of a trial get overlooked? What experienced ICU physician would ever make this kind of mistake? I can’t think of one. In retrospect, the whole debacle parallels the past few years’ global amnesia regarding the protective effects of natural immunity while embarking on a mad pursuit to vaccinate the world against a highly mutagenic virus that they’ve likely recovered from.

It was our later experience as advocates (ugh) of the medicine called ivermectin in the early treatment and prevention of Covid that would finally make us realize that the categorical destruction of a proven therapeutic was not borne of stupidity. The people in charge knew EXACTLY what they were doing . . . and always had. We should have figured that out already with what was happening to IVC. But we didn’t. We were slow on the uptake, or rather, like almost all physicians working in what I now call The System, simply too trusting of its institutions and leaders and the objectivity of the science published in the top medical journals.

Our interest in the use of intravenous vitamin C in sepsis is what brought Paul and me together as colleagues and then friends, a friendship that began after I wrote an editorial that was published in a major medical journal called Chest and had been strongly influenced by Paul’s published work.

I was shocked when he wrote me an email congratulating me on its publication. Little old me got a personal note from the great Paul Marik? He also attached an important paper that he thought I should have discussed and referenced. (In my defense, that paper had been published after I had submitted my editorial.)

Like many others in my field, I was an avid admirer of Paul. He was an intellectual giant in critical care medicine, the embodiment of a thought leader. What’s funny is that so many so-called thought leaders are not leaders at all, but rather status quo-supporting, orthodoxy-upholding doctors with positions of authority or profound pharmaceutical or agency influence. They lead thoughts, alright . . . the ones they’re guided, bribed, or forced to lead. Conversely, Paul’s lectures at major academic conferences were always overflowing as his research and insights often led to conclusions that completely opposed prevailing orthodoxy and standards of care in the ICU. (See chapter four for a thorough probe into Paul’s career exploits.)

More important than the fact that Paul often argued against the prevailing guidelines issued by the professional academic societies is that his data, analyses, and conclusions were nearly always impossible to rebut logically or scientifically. Time and again, Paul would show that the standard of care was not based on correct scientific data or an accurate understanding of the underlying pathophysiology of the disease or treatment. He has a gift for compiling and analyzing evidence and presenting it in such a way that is both compelling and humbling. Yet time and again, the academic societies were neither compelled nor humbled.

After receiving his email in 2016, I didn’t write back to Paul for almost eighteen months. I kept his note bolded in my inbox waiting for a time when I felt I could reply, but the truth is I just couldn’t. I was consumed in a health crisis involving one of my three daughters. Following a severe streptococcal infection, she had developed a serious, acute neuropsychiatric syndrome called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) at the time but now known as PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). She suffered intense neurologic symptoms that were traumatic for her to experience and unbearable to witness. Worst of all, they had suddenly appeared in a beautiful, social, happy, neurodevelopmentally normal, and highly intelligent child.

Her unexplained suffering was excruciating. Further, her symptoms were accompanied by a debilitating separation anxiety from my wife, Amy. This was especially challenging considering that Amy is also a pulmonary and critical care doctor who sub-specializes in a category of rare and difficult to treat disorders collectively known as interstitial lung disease (ILD). Although Amy was on a significant leave from work to care for our daughter, she tried to keep her one clinic day on Wednesdays.

Wednesdays were brutal.

During those years, I was on edge from the moment my daughter woke up to the time we could somehow get her to sleep at night. I was deteriorating physically and psychologically from stress and lack of self-care. My wife, on the other hand, was an absolute rock. When I acted out, Amy kept her cool. Still, the ordeal took an undeniable toll on us both.

Our daughter’s illness consumed our days, our thoughts, and all of our intellectual and physical energies. In the span of just a few months, we had seventeen different encounters across emergency room physicians, pediatricians, neurologists, psychologists, and psychiatrists. One of the latter ultimately diagnosed my daughter with functional neurological disorder (FND), which is classified as a mental health condition. This is when I realized these experts knew nothing at all about this syndrome. The parallels to what is happening now to those with Covid vaccine injury syndromes—many of whom receive the same damning diagnosis as my daughter did—is beyond disturbing.

Our family PANS/PANDAS crisis was the first traumatic battle I had with the health system and one I will write about again at some point in the future. Compounding the PTSD is the belated knowledge that PANS/PANDAS exploded in frequency and severity at the same time the childhood vaccine schedule exploded in the late 1980s. I didn’t know at the time that my family was being destroyed by a vaccine-associated disease.

Words cannot explain how profoundly disturbing that eventual realization was.

Fortunately, after months of delay in diagnosis and treatment, we finally found a brilliant pediatric neurologist. Despite her colleagues’ misgivings and even condemnation for being willing to treat a disease that doesn’t exist, she was able to return my daughter to her completely normal neurological and social functioning. Not that recovery was fleeting or easy; it took months in an ICU with a combination of aggressive treatments including high-dose corticosteroids, plasmapheresis, intravenous immunoglobulins, and a B-cell depleting cancer agent.

So, to say that Covid is not my first scrimmage in battling modern medicine is a gross understatement. As a result of that experience, I got heavily involved with and became a board member of the incredible nonprofit now called the Neuroimmune Foundation² (formerly The Foundation for Children with Neuroimmune Disorders). Our mission was simple: to increase awareness and diagnosis of the disease, educate providers on treatment options, and fund research into better understanding the biological causes, diagnostic measures, and therapies. The founder and executive director of the foundation, Anna Conkey, became a close friend, colleague, and confidant, and I owe her the world for her help and support during that difficult time and throughout my Covid challenges. I love Anna and consider her a truly remarkable human being. (If you are able, please donate to neuroimmune.org.)

For the next several years, I moderated numerous webinars, lecture series, and symposia for the Neuroimmune Foundation, interacting with clinicians, scientists, and researchers in the disease. But in June 2021, after moderating that year’s annual conference, Anna received complaints that I was too controversial to be associated with the foundation due to my public advocacy in Covid and with the FLCCC. I no longer host those educational events.

If my PANS battle was my first meaningful clash with academic medicine, my second was my experience teaching, treating, and researching the use of IVC in sepsis with Paul Marik. The IVC in septic shock story started when Paul began incorporating it into his treatment of such patients in 2016 based on a review and critical analysis of a few small studies showing absolutely dramatic reductions in mortality. He then published his experience with the first 47 patients he treated by comparing their outcomes with 47 patients selected from the prior year that were propensity matched to the IVC-treated patients in terms of age as well as cause and severity of sepsis. He reported that in IVC-treated patients, only 8 percent died, while in matched patients not receiving IVC, 40 percent had died. Let that sink in for a second.

There are very few medical interventions that lead to such a profound reduction in mortality. One way in which we measure the potency of an intervention in medicine is via use of a measure known as the Number Needed to Treat (NNT) to save a life (or prevent a stroke or illness). Paul’s study found an NNT of 3.1, which meant that for every three patients he treated with IVC, one life that would otherwise likely end would be saved. A more disturbing way of putting it is that, for every three patients denied IVC in early sepsis, one would die unnecessarily. Let that sink in for a second.

Note that the most powerful intervention in medicine is the use of a defibrillator in someone whose heart has stopped. That intervention has an NNT of 2.5. Paul had discovered a therapy nearly as powerful in terms of its life-saving properties.

Paul published his study in the prominent journal Chest in 2017. I should note that his protocol was not just centered around the use of IVC but also included IV corticosteroids and IV thiamine. Here’s the crazy part: When the paper and its results were published, I actually dismissed it as too good to be true. There was no way that IVC could have that effect. It was unheard of. I had never come across any therapy that reduced mortality in the critically ill so profoundly. It just wasn’t possible. Even if it was from the great Paul Marik.

Please keep in mind this is pre-Covid Pierre we’re talking about here; the New York Times–blind, brainwashed disciple of The System. To that end, another reason I ignored Paul’s study is that I had a keen and longstanding disdain for vitamins as any sort of therapeutic in acute illness. With a tiny, grudging exception for some chronic conditions, I considered the vitamin industry to be a billion-dollar scam that preyed on people who didn’t need or benefit from them. As a system physician, I had been drowning in negative vitamin trials published in the most prestigious medical journals in the world for years; vitamin D trials for all sorts of illnesses and cancers, as well as vitamin E, A, and C in everything from immune disorders to cardiovascular disease. Enough with the stupid vitamins, I thought, they’re a total scam! The science is clear, it’s right here in this esteemed journal. (See where this book is going?) What I didn’t know was that the difference between oral vitamin C and intravenous vitamin C is like the difference between a pistol and a machine gun.

A third reason I paid little heed to Paul’s paper is that it generated quite a bit of media buzz. His hospital’s press office allowed television stations to interview his nurses, who all but called the protocol miraculous. It was such a weird, unprecedented way to disseminate knowledge of a scientific breakthrough that I suppose I found it unprofessional, or at least unbecoming. I had never heard of a TV station interviewing nurses about some miracle therapy based on what I foolishly thought was a low-quality study. Of course, I now know such studies are highly valid, and their conclusions, especially when so large, are irrefutable.

So, for a bunch of ill-conceived reasons, I ignored Paul and his little study. I didn’t know anyone at the University of Wisconsin who was using it, and I wasn’t in the market for any snake oil.

Fast forward about a year. It was early 2018 (so still pre-Covid) and I was the director of the Medical ICU at the University of Wisconsin and the Chief of the Medical Critical Care Service. I was having a brutal week. My primary Medical ICU was so slammed with patients that they overflowed to other ICUs (Cardiac, Neurosurgical, Surgical).

Not-so-fun fact: My ICU mortality at UW was about 8–15 percent of patients admitted to me. That was the average. On a really bad week, I might see as many as 20–25 percent of my patients die. Feeling helpless and following my long-held principle in ICU medicine, "if what you’re doing isn’t working, change what you are doing," I decided, what the hell, why not try Marik’s stupid IV vitamin cocktail? (Sorry, Paul.) I had nothing to lose.

The first patient I tried it on was a man decompensating from severe septic shock. He was already in advanced multi-organ failure, but his understandably distressed family was begging me to do everything I could. Unfortunately, despite initiating Paul’s protocol, he died later that day. I was unsurprised by this as I already knew that nothing worked in actively dying patients. Still, it seemed totally harmless (which it was) given it consisted of a couple of IV vitamins and a corticosteroid (the latter of which was already part of my practice), and morally it felt better than doing nothing at all, so I figured I’d try it again.

The second patient was a female with necrotizing fasciitis—a deadly bacterial infection known as flesh-eating disease. I knew I needed a surgeon, so I consulted my friend and colleague at the time, Dr. Hee Soo Jung, who rapidly got his team together to take the patient to the OR. There they would do a debridement of her abdominal soft tissues which were red, hot, and showing evidence of an infection with a gas forming organism (a really bad sign). In the hours before she went to the OR and after starting the protocol, I was watching her closely. Her condition seemed to be stabilizing even prior to going to the OR. Although I was not at all convinced that Paul’s protocol was as miraculous as his paper and the nurses on TV said it was, I was definitely intrigued; when she survived, that intrigue turned to genuine hope.

What happened next was transformative. A few days later, I administered the therapy to a newly admitted ICU patient with severe septic shock. He was a sixty-five-year-old man, seven days post–bone marrow transplant. Patients in the first seven days after transplant typically have no white cells to fight off infections and bacterial sepsis is a common complication. And boy was he septic. He was on high-dose intravenous vasopressor therapy, had altered mental status and labored breathing, and his kidneys had shut down. His wife was at his side, terrified that he was going to die.

So was I.

He looked terrible. I started him on what we later dubbed the HAT protocol (hydrocortisone, ascorbic acid, i.e., vitamin C, and thiamine) and what happened over the next few hours was something I had maybe seen once before amongst the thousands of patients I had treated for septic shock.

The nurses reported a rapid decrease in the need for vasopressors, an abrupt resumption of urine flow, a clearing of his mental status, and an easing of his breathing. I was thrilled by his progress, but that was nothing compared to what happened the next morning. He was the first patient I checked in on, and I was shocked to find the man sitting up in the armchair next to his bed, a tray of food next to him, eating breakfast, talking pleasantly with his wife. He was off all vasopressors and there was a full urine collection bag at the end of his catheter. The nurse informed me that he was being transferred back to the bone marrow transplant ward. Less than twenty-four hours from arrival in the ICU in severe septic shock?

I was exhilarated. Holy crap. That stuff works! I had never discharged a patient within twenty-four hours of neutropenic septic shock. Dr. Mark Juckett, the bone marrow transplant attending physician and a colleague I knew well, approached me. What did you do to that guy? he asked. I thought for sure he would be on a ventilator and dialysis and he’s actually going back upstairs?

I blushed in almost embarrassment as I replied, Mark, I’m telling you, I gave him high dose intravenous vitamin C and it turned him around! The attending wasn’t really sure what to say to that, so he just shrugged and mumbled great and continued on his patient rounds.

It was striking that an experienced bone marrow transplant attending had also noticed the sudden and unexpected physiologic reversal in such a short time. Suddenly, the word miraculous didn’t seem so far-fetched.

Feeling as if I’d uncovered the key to the universe, I continued deploying Paul’s HAT protocol and seeing dramatic clinical responses in extremely ill patients. I started a research study to collect data retrospectively in order to measure the outcomes of patients who had been treated with his protocol compared to patients who had not. I should note that within a couple of weeks, I started to see that in some patients, there was no response or minimal ones. I wasn’t sure why and was a little concerned because I had become highly confident in the protocol’s efficacy; cocky even. Every time I started the therapy, I had developed a habit of predicting to the nurse or my physician trainees what would happen next. Although I did have some concern over the occasional lack of response, the vast majority of patients receiving the protocol demonstrated dramatically positive alterations in their clinical trajectories.

I could not stop thinking about how absolutely life-altering this was. I had been treating septic shock for well over a decade and now had a treatment that was turning almost every patient around, successfully and quickly.

I finally decided to reply to Paul’s email of almost eighteen months earlier. I told him how much I appreciated his congratulatory note on my editorial, and how my lack of reply was solely due to the circumstances surrounding my daughter’s illness. I explained that I simply had not had the spirit or the emotional stability to write back to him at the time, but I was writing now because I wanted to talk to him about how IV vitamin C had completely transformed my practice and understanding of the treatment of septic shock.

His email reply to me was incredibly sweet and understanding; he gave me his phone number and said we should talk. I still remember that first conversation and exactly where I was and how we spent over two hours on the phone. He detailed what he was seeing in his ICU, how almost nobody required dialysis for acute kidney failure anymore and how the hospital nephrologists were noticing—and not necessarily in a good way. (A significant source of their income is from the reimbursement they get from providing acute dialysis.) He explained how his septic shock patients’ average ICU stay was